PURPOSE: To describe the use of an anti-CD20 monoclonal antibody, Rituximab, in the treatment of orbital lymphoma. METHODS: Prospective, noncomparative, interventional case series of 8 patients treated with rituximab. Management, side effects, and outcome were recorded. RESULTS: Five patients had initial complete response, 2 had partial response, and 1 had ...

BACKGROUND: Treatment of bullous pemphigoid (BP) with systemic immunosuppressive agents, in particular with systemic corticosteroids, has many long-term side-effects. A dozen reports were published regarding the efficacy of topical corticosteroids in the treatment of bullous pemphigoid. OBJECTIVE: To evaluate the efficacy of potent class I topical corticosteroids in relation to ...

The authors treated 10 patients with multifocal motor neuropathy (MMN) responding to an initial course of IV immunoglobulin (IVIg) with periodic infusion for 5 to 12 years (mean 8.2 years). At last follow-up, only two patients had maintained the maximal improvement achieved during therapy while eight worsened despite increasing Ig ...

OBJECTIVE: Our aim was to compare the 12-month safety and efficacy of fluticasone propionate (FP) and sodium cromoglycate (SCG) in children aged 1 to 3 years with mild to moderate recurrent wheeze. METHODS: The study was a randomized, parallel-group, open-label multicenter study of 625 children, aged 1 to 3 years, ...

BACKGROUND: Although systemic corticosteroids are effective against cutaneous sarcoidosis, alternative therapies are needed. OBJECTIVE: We sought to assess the efficacy and tolerance of thalidomide for cutaneous sarcoidosis. METHODS: We performed a retrospective evaluation of thalidomide (100-200 mg/d) in 12 consecutive patients with cutaneous sarcoidosis treated in a university hospital between ...

OBJECTIVES: To assess the efficacy and safety of intravenous cyclophosphamide (CYP) used in severe and refractory juvenile dermatomyositis (JDM). METHODS: Retrospective case note review of the outcome of 12 patients. RESULTS: Assessment at 6 months of therapy in 10 of the 12 patients showed a significant improvement in muscle function ...

Paraneoplastic neurological disorders are devastating remote effects of malignancy. Despite compelling evidence of an autoimmune pathogenesis, empiric immunomodulatory treatment of these disorders is often ineffective. However, very few systematic studies have been conducted, and the treatment of patients without active malignancy has not been addressed. We conducted a prospective open-label ...

BACKGROUND: Leukotriene receptor antagonists have become an integral part of asthma treatment as an add-on therapy for patients with moderate disease activity. OBJECTIVE: To determine whether in vivo treatment with montelukast, a leukotriene receptor antagonist, at the recommended therapeutic dose affects neutrophil functions which are essential for host defense. METHODS: ...

BACKGROUND: Budesonide, a widely used inhaled corticosteroid (ICS) with a favorable therapeutic ratio, is available via a dry powder inhaler (Pulmicort Turbuhaler) and as a suspension for nebulization (Pulmicort Respules). METHODS: MEDLINE and an AstraZeneca database were searched to identify relevant controlled clinical trials published between 1986 and 2002 using ...

OBJECTIVE: This study was performed to determine the benefits and risks of multiple courses of corticosteroids in patients with preterm premature rupture of membranes (PPROM). METHOD: We retrospectively evaluated the pregnancy and neonatal outcomes of women with singleton pregnancies, who were admitted at 24-32 weeks of gestation due to PPROM. ...

OBJECTIVE: The optimal duration of immunosuppressive therapy and the timing of treatment for treating membranous nephropathy (MN) have yet to be established. We examined outcomes of a short course of cyclophosphamide alternating with prednisolone for MN patients with nephrotic syndrome. METHODS AND PATIENTS: Cyclophosphamide (2 mg/kg/day for 8 weeks) combined ...

A retrospective study of strongyloidiasis cases was carried out in Sfax University (Tunisia), between 1989 and June 2001. Diagnosis was done by direct stool examination, concentration methods, Baermann larval extraction and fecal culture. Strongyloidiasis was diagnosed in 27 patients of whom 77% were males living in rural areas under low ...

We reviewed the charts of all HIV-negative patients 15 years of age or older in whom tuberculous meningitis was diagnosed and treated without corticosteroids at Srinagarind Hospital, Khon Kaen, Thailand during the period of 1997-2000. Forty-five patients were included in this study. The clinical manifestations were subacute to chronic meningitis ...

OBJECTIVE: To evaluate the efficacy of pentoxifylline in the treatment of refractory nephrotic syndrome secondary to lupus nephritis. METHODS: We studied 11 patients who met the following inclusion criteria: (1) systemic lupus erythematosus (SLE) according to the American College of Rheumatology criteria; (2) lupus nephritis class III, IV, or V ...

Despite treatment with valproic acid and neuroleptics, a significant proportion of patients with Sydenham chorea (SC) remain with chorea. We evaluated the effect of intravenous methyl-prednisolone followed by oral prednisone in patients with SC refractory to conventional treatment. Patients were enrolled in the study if they failed to improve with ...

To investigate clinical aspects of the neutropenia induced by high-dose intravenous immunoglobulin therapy (IVIG) we performed serial hematology, including differentiation of white blood cells (WBC), before and after 22 instances of IVIG in 16 patients with neuroimmunologic disorders. WBC and neutrophils showed a significant decrease with a nadir 2 days ...

BACKGROUND: Specific immunotherapy (SIT) is a well-documented treatment for respiratory allergy. However, the major risk of SIT is the development of systemic anaphylactic reactions. OBJECTIVES: To evaluate the safety of SIT given by subcutaneous route for 3 years to patients with seasonal allergic rhinitis (AR) with or without asthma. METHODS: ...

PURPOSE: To describe the findings and outcomes in eosinophilic granuloma (unifocal Langerhans-cell histiocytosis [LCH]) of the orbit and to explain the paradox of aggressive bone destruction responsive to minimal intervention. METHODS: Retrospective, consecutive, interventional case series of patients treated from 1985 to 2001. Minimum inclusion criteria were demonstration of CD1a ...

Giant cell arteritis (GCA) is a vasculitis of unknown etiology that affects medium-sized and large arteries, and is the most common form of vasculitis in populations of predominantly Northern European ancestry. If left untreated, GCA can lead to significant morbidity including blindness, stroke, aortic aneurysm and dissection, as well as ...

BACKGROUND: The purpose of the present study was to evaluate the efficacy of corticosteroids in the treatment of Graves' ophthalmopathy in comparison to other treatment modalities. MATERIAL/METHODS: 15 studies were identified but only 14 were included in the final analysis, 5 cohort and 9 randomized. A total of 813 patients ...

BACKGROUND AND AIM: Recurrence of sarcoidosis following complete remission and after a prolonged time of inactivity is considered a very unusual clinical event. The aim of this study was to investigate the clinical characteristics of a series of patients diagnosed as having recurrent sarcoidosis. METHODS: Recurrent sarcoidosis was defined as ...

IVIg products may be applied for the provision of antibodies in patients with primary or secondary antibody deficiency syndromes or with the aim of immune modulation in patients with autoimmune diseases. The average dose for the provision of antibodies is 400 mg/kg per month while much higher doses are needed ...

BACKGROUND: Guillain-Barré syndrome (GBS) is an acute acquired demyelinating polyneuropathy, presumed to be immune-mediated. Intravenous immunoglobulin (IVIg) has been used to treat GBS and was found to be effective. However, a well-controlled study of pediatric GBS has not been conducted in Japan. Therefore, to evaluate the efficacy of IVIg in ...

Pharmacological treatment of diffuse systemic sclerosis (SSc) directed at the tissue fibrosis has generally been ineffective. Many immunosuppressive drugs have been tried as therapy for SSc, regardless of the disease subtype and/or stage. The aim of this study was to show the efficacy and the toxicity of oral cyclophosphamide and ...

Hughes R A C RA Department of Neuroimmunology, Guy's, King's and St. Thomas' School of Medicine, London, - - 2003

To provide an evidence-based statement to guide physicians in the management of Guillain-Barré syndrome (GBS). Literature search and derivation of evidence-based statements concerning the use of immunotherapy were performed. Treatment with plasma exchange (PE) or IV immunoglobulin (IVIg) hastens recovery from GBS. Combining the two treatments is not beneficial. Steroid ...

BACKGROUND: Nonsystemic vasculitic neuropathy (NSVN) is an uncommon disorder. Few series with small numbers of patients have been reported. The prognosis and treatment of patients presenting with NSVN remain uninvestigated. The authors sought to address these issues by assembling a large retrospective cohort with extended follow-up. METHODS: All nerve biopsies ...

The 1997 National Asthma Education and Prevention Program (NAEPP) recommends a severity classification scheme to optimize the use of anti-inflammatory therapy for persistent asthma. Physician documentation of asthma severity is often used as a quality assurance measure. To test the hypothesis that physician documentation of asthma severity is associated with ...

BACKGROUND: Dexamethasone-cyclophosphamide pulse (DCP) therapy for the pemphigus group of disorders is being widely used in India after its introduction in 1986. However, there are certain limitations to its application due to the serious side effects of cyclophosphamide. METHODS: Between 1995 and 2001, we treated 41 patients of pemphigus with ...

AIMS: To characterize presentations due to acute asthma at Australian emergency departments (ED), including their severity, treatment and disposition. METHODS: This prospective, observational study involved 38 departments of emergency medicine throughout -Australia participating in the Snapshot of Asthma Study Group project 2000 and 2001. Data were collected for patients presenting ...

BACKGROUND: The complications associated with the use of systemic corticosteroid therapy have prompted a search for alternative agents. However, these agents are themselves associated with increased risk of myelosuppression or malignancy. METHODS: The present study included twenty patients with recalcitrant pemphigus or steroid induced side effects who were treated with ...

Previous reports show that addition of omalizumab to standard therapy reduces asthma exacerbations and simultaneously decreases use of inhaled corticosteroids (ICSs) and rescue medication in patients with allergic asthma. To determine the effect of omalizumab on long-term disease control in patients with severe allergic asthma. The present study concerns the ...

OBJECTIVE: To evaluate the role of an immunosuppressive regimen consisting of azathioprine and prednisolone on the clinical, immunological, and angiographic outcome in patients with active Takayasu's arteritis (TA). METHODS: Between January 1996 and January 2001, of 65 consecutive newly diagnosed patients with TA not previously treated by any immunosuppressive therapy, ...

BACKGROUND: Topical corticosteroids are the mainstay treatment for oral lichen planus (OLP), but some authors suggest that systemic corticosteroid therapy is the only way to control acute presentation of OLP. METHODS: Forty-nine patients with histologically proven atrophic-erosive OLP were divided into two groups matched for age and sex. The test ...

BACKGROUND: The coadministration of long-acting inhaled beta(2)-agonists and inhaled corticosteroids is the most effective treatment for persistent asthma. OBJECTIVE: This meta-analysis aimed to determine the efficacy of fluticasone propionate and salmeterol inhaled from a single inhaler (combination therapy) or from separate inhalers (concurrent therapy). METHODS: Four similarly designed double-blind studies ...

PURPOSE: To evaluate the clinical experience with methotrexate as a first-line corticosteroid-sparing drug in patients with resistant ocular inflammation. METHODS: We retrospectively studied 39 consecutive patients with uveitis (n = 36) or scleritis (n = 3) who were treated with methotrexate following inadequate control with corticosteroids lasting five years. Criteria ...

OBJECTIVE: To determine the frequency, characteristics, and short term outcome of patients who have biopsy-proven giant cell arteritis (GCA) but no local symptoms that can be attributed to vasculitis inflammation [silent temporal arteritis (TA)] throughout the pretreatment course of the disease or an observational period lasting at least 2 months. ...

Mycophenolate mofetil is increasingly being used as a corticosteroid-sparing agent in immunosuppressive regimens. To elucidate the effectiveness of mycophenolate as adjuvant therapy in the treatment of both pemphigus vulgaris and pemphigus foliaceus. Historical prospective study. University hospital. The study included 42 consecutive patients with pemphigus (31 with pemphigus vulgaris and ...

BACKGROUND: Pemphigus foliaceus (PF) and pemphigus vulgaris (PV) are autoimmune blistering skin diseases usually treated with high-dose systemic corticosteroids and other immunosuppressants that may cause severe side-effects. Plasmapheresis also has been demonstrated to be of benefit in the treatment of pemphigus. In contrast to plasmapheresis, staphylococcal protein A immunoadsorption (PA-IA) ...

PURPOSE OF REVIEW: To evaluate recent developments on emergency department inhalotherapy in non-intubated acute adult asthma patients. RECENT FINDINGS: There is evidence that high-flow oxygen can be associated with hypercarbia, and that full humidification of the inspired gases should be recommended. On the contrary, there is a lack of evidence ...

Asthma is a chronic inflammatory illness with acute exacerbations, which often is encountered in the ED setting. Knowledge of the presentation and treatment of asthma is crucial for any physician treating patients with this disease. Beta-agonist, anticholinergic, and corticosteroid therapy continue to be the mainstay of emergency therapy despite advances ...

OBJECTIVE: In short term studies, asthma symptoms and pulmonary function have been reported to improve during and after medical treatment or surgical correction of gastroesophageal reflux (GER). In this study, we aimed to determine whether prolonged treatment of GER altered the long term natural history of asthma in asthmatics with ...

OBJECTIVE: To evaluate the effects on signs and symptoms of a coexisting vernal keratoconjunctivitis in patients treated with oral montelukast sodium for asthma. METHODS: Twelve patients with vernal keratoconjunctivitis and asthma were enrolled in this pilot study. Topical eyedrops or any systemic treatment was discontinued for at least 7 days ...

BACKGROUND: Recurrent aphthous stomatitis (RAS) is a common oral condition, the etiology of which remains largely unclear. Numerous therapeutic protocols have been tried. Apart from immunomodulators, no therapy is unequivocally effective, and many systemic therapies have potential adverse effects. OBJECTIVE: To compare, in patients with frequent RAS unresponsive to conventional ...